Wednesday, September 9

America’s love affair with caffeine has sparked a crisis of overdoses

"The difference between a safe amount and a toxic dose of caffeine in these pure powdered products is very small," the FDA said. "Furthermore, safe quantities of these products can be nearly impossible to measure accurately with common kitchen measuring tools."

Today, caffeine comes in all shapes and formulations -- Red Bull and Monster energy drinks, "Stay Awake" pills, Jolt gum. The most potent form, the pure powdered kind that's meant for people to mix into their food, is sold in bulk in bags or canisters that can cost as little as $10 per pound. A single teaspoon can be packed with as much caffeine as 28 cups of regular coffee.

The new products have led to an alarming public health development in recent years that was unheard of in the many previous decades that people enjoyed caffeine: a rash of thousands of overdoses and reports of addiction and withdrawal.

While rare, there are even deaths: A 14-year-old with a heart condition died after going into cardiac arrest shortly after she drank two caffeinated energy drinks in 24-hours. A 19-year-old Connecticut resident who took a dozen caffeine pills. And a healthy Ohio teen who was a high school wrestler died after consuming powdered caffeine.

Food and Drug Administration has been so alarmed that it's mounted an aggressive effort to warn consumers about the risks of caffeine products and to take manufacturers to task for the way they are marketed.[...]

When it's taken in moderation -- usually defined conservatively as the amount in one to two cups of coffee a day -- most researchers have concluded that caffeine presents little to no risk to people's health. In fact, some studies have found that the stimulant may have some protective effects from diseases like Parkinson's and cancer.

But when used in excess caffeine can be deadly.

In recent years, hospitals have reported an uptick in cases of caffeine overdose in emergency rooms and this year from Jan. 1 to July 31, poison centers across the country logged 1,675 reports involving energy drinks. Nearly two-thirds were in children 18 and younger.

[...]

Plenty more in Cha's report, including a chart showing that even preschoolers are ingesting the stuff and in alarming numbers. Chocolate milk, fed to small children as a tasty alternative to plain milk, contains up to 16 mg of caffeine per glass. My concern is that in their tendency to label 'excess' caffeine intake as an addiction, researchers, insurers and health officials are missing the forest for the trees:

[In] 2013, when the new bible of American psychiatry -- the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5 for short -- was released, "caffeine withdrawal" was added as a bona fide mental health disorder -- a move that practically guarantees billing codes for insurance company reimbursement.

The need for ever higher levels of THC isn't addiction; it's tolerance. Same happens with food substances that provide a kind of 'kick' including sugar, chilis, salt, caffeinated products. After a time of using the substance, one has to use more and more to get the same 'kick' feeling.

It's subtle; one starts using more salt to get the salty taste, more sugar to get the sweet taste. And so on. But caffeine is not only a foodstuff; it's also a drug -- yet curiously it has no ability to wake people up or keep them awake. One simply gets used to the caffeine 'feeling' -- the effects of the drug -- and associates that with wakefulness.What's to be done? When you consider that half of adults living in the United States are diabetic or pre-diabetic, it's become a matter of life or death to explain that while society has changed, the human body hasn't. It used to be that our sweat glands could expel higher than healthy amounts of compounds from foodstuffs and drugs such as caffeine, and hard physical labor also efficiently processed large caloric intakes. But most of us are no longer doing hard labor for hours on end every day. It's also important to explain the taste tolerance phenomenon, and get people to re-educate their taste buds. If you start 'cutting' a glass of sugar-containing cola with a little water, and eventually get it up to half water and half cola, the taste of uncut cola, even with ice cubes added to the glass, is poison. It's undrinkable; you'll spit out the mouthful.How did you get used to drinking a poison taste? Little by little.So the general idea is to back out the same way you stumbled in. Little by little. That is the best tactic for getting away from too much coffee. If it's brewed coffee, start with adding a quarter of decaffeinated grind, then gradually work up to half and half, and so on, until it's all decaffeinated. And read the labels on processed food you buy while asking, 'Does this really require sugar?' (Sugar has at least 10 different names, by the way.) Who the hell puts sugar in chicken soup? In mayonnaise? But it's done, even though it's possible with some effort to find mayonnaise without sugar. (Duke's is one such brand and Whole Foods makes sugar-free mayo.) Amazing but true, that's the way mayo is supposed to taste. I'm surprised that mustard doesn't have sugar added, but give them more time.But again, little by little, people got used to a sweet taste in all kinds of foodstuffs and recipes that don't require sugar -- then gradually they needed the sweet taste to be sweeter and sweeter, just so it tasted sweet. Same with salt.in short, every means must be found to get it through to your brain that the world has changed while the human body hasn't. It's annoying to consider that with so many large issues to be dealt with, we have to attend to such picayune details. But it's on such details that our fate as a race now turns.Part of the details is making a clear distinction between addiction and tolerance. ********

"What Julia Child did for French cooking, Pundita is doing for foreign policy discussion. She's opened a haute pursuit to ordinary people." - Caesar Rodriguez

"Few bloggers think as deeply as Pundita does. And few have her foresight." - Uppity Woman

"There is no other blogger like Pundita. She has carved a niche - part history and part humint - that makes any essay of hers a thing unto itself. In addition there are the sparkles of her dry wit sprinkled through her work." - Dymphna, Gates of Vienna